What is a healthy relationship?

Ok I am going to say it. My husband truly is my best friend, but what does that actually mean? Are there different criteria for besties you are married to versus ones that you are not married to or in a relationship with? I don’t actually know the answer to this one, but I can define what I mean when I say it. I mean that my husband is the first person I think of to talk about my day with, to tell a secret to, to giggle with, to hold hands with, to spend the day with, or to just sit and do nothing with. He really is at the top of the list. I still get a stupid smile on my face( most of the time) when I think of him or refer to him in conversation. We still have a lot of fun. That’s my definition of a best friend. This does not mean that we never fight or argue, but we have never resorted to hitting or any other violence. This does not mean that sometimes I don’t get so pissed off at him that I don’t want to speak to him for awhile. Both spectrums are fully represented. No one can make me happier and no one can make me angrier. Gladly, these two situations don’t usually present at the same time, if you don’t count menopausal hormone swings. I still have other friends and I still lead my own independent life with my own goals and pursuits. I travel alone for business or with friends sometimes. I “do my own thing.” He is not up my proverbial butt all the time. I still consider that pretty normal and healthy.

Sometimes when people say those words, they mean something entirely different and, in my opinion, not so healthy. I know people who talk about their partners being their best friends and what I see, as an outside observer, is a relationship that is fraught with obsession, possession, and pathologic co-dependence. They are attached at the proverbial hip with their partners. They identify themselves only as a matched set. They are uncertain of who they are when their partner is not around. They have no outside friends or unshared activities. They have a habit of checking/seeking permission from their partner to do anything. They don’t speak their minds for fear of starting an argument. To me, this is unhealthy and potentially leads down a slippery slope to a controlling or even abusive relationship. I get that traditionally we think of an abusive relationship in terms of physical abuse, but emotional abuse leaves just many scars and they last longer.

So, what is a healthy relationship? I find that this is a question that seems to be getting more and more difficult to answer for both adults and adolescents. Did you know that roughly 1.5 million high school boys and girls in the U.S admit to being intentionally harmed or abused in a relationship at one point and that 1 in 3 young people will be in an abusive or unhealthy relationship at some point in their lives. That means that 33% of adolescents in America are victim to sexual, physical, verbal, or emotional dating abuse. This behavior is starting as young as six th grade! Young women who are in an abusive relationship are 6 times more likely to become pregnant or contract a sexually transmitted infection and are 50% more likely to attempt suicide. Add on top of this that most of this abuse goes unreported because of fear of exposure or just lack of knowledge about possible recourse. The stats for adults are not any better in terms of unhealthy relationships. Did you know that a woman is assaulted or beaten every nine seconds in the United States. 1 in 3 women, and 1 in 4 men, have been in abusive relationships. 1 in 5 women and 1 in 7 men have faced severe physical violence as well. 20 people are abused by an intimate partner every minute, which adds up to 10 million people each year. Just like with the teens, up to 75% of this is not reported.

Ever time I look at those statistics, I am sobered once more about the reality of them. Still, I feel that awareness is an essential ingredient in targeting this devastating issue. This is truly a situation in which putting your head in the sand can make a life or death difference. I deal with domestic violence in my office frequently. I have a confidential questionnaire that each patients fills out with her visit that starts off with some generalized questions and slowly leads up to questions about domestic violence. This way, she can fill it out confidentially and then we can open up a dialogue once she is safely back in an exam room. Sometimes, I am the first person who has ever even asked the question in her whole life. These are often women who have friends, relatives etc who have seen bruises or noticed behaviors but don’t consider it their place or are afraid to mention it for fear of repercussions and or potential danger to themselves.

I think that sometimes abuse victims face a culture of blame. Myths about domestic violence are common, particularly among those who are likely to abuse their partners. Some people say that if they get hit, they will hit back and then the next bit of twisted logic is that women who slap their partners should expect whatever violence their partner can dish out because they deserve it. I hear women say that they got ” what was coming to them” as a result of a particular behavior. This is false! There is no behavior that justifies physical violence or emotional abuse. All of these myths contribute to an overall culture of violence and victim-shaming.

People talk about the victim as being a part of the cycle of abuse and have no idea why the person doesn’t leave the relationship. This is an easy statement to make on the outside, but these same people are not intimately involved in that relationship. They don’t realize what is potentially at stake with leaving. Sometimes there are children involved and the victim feels that they will be more at risk with leaving. Sometimes there is a very real danger that the victim themselves may be killed if they try to leave. Sometimes the victim cannot leave because their partner offers financial security. Victims talk about the very strong psychological pull of the ” honeymoon period.” The honeymoon period is that period of calm when things appear good again and the abuser has apologize and made temporary changes and restored the often desperate and fleeting hope that the victim has that the relationship can be saved. I have patients tell me that this honeymoon period is all that have to live for at certain points because they are so broken by the abuse and the relationship that they can no longer see or evaluate their lives clearly.

So, how do you spot an abusive relationship? What are the signs?

1. Humiliating or embarrassing you

2. Constant put-downs

3. Hypercriticism

4. Refusing to communicate

5. ignoring or excluding you

6. Affairs with other people

7. Provocative behavior with the opposite sex

8. Unreasonable jealousy

9. Extreme moodiness

10.Mean jokes or making fun of you

11.saying ” I love you, but…

12. Guilt trips

13. Domination and control

14. Making everything your fault

15. Withdrawal of affection

16. Isolating you from friends and family

17. Using money to control

18. Constant calling or texting when you are not with them

19. Threatening to commit suicide if you leave

Ok now that you know the signs. What do you do about it? What do you do when you notice it in someone else’s relationship? If you are the victim, the obvious, but not easy, answer is to break off the relationship and leave. Call the National Domestic Violence Hotline at 1-800-799-SAFE. All phone calls are confidential. This is a 24 hour hotline to talk confidentially with anyone in the United States who is experiencing domestic violence, seeking information, or questioning if his or her relationship is unhealthy. This same hotline also provides lifesaving tools and immediate support to empower victims and survivors and also provides support to friends and family. They have an online chat as well if you do not feel comfortable or are unable to call. If you are the observer, don’t wait for the victim to approach you. Ask them in private and let them know your concerns. Tactfully point out the signs that you have noticed. Offer to be there for them to talk and promise confidentiality. Direct the victim toward resources such as the national hotline. You could save a life. Have a fantastic day!

Dr. Katz